Angioplasty and stent placement - carotid artery

Definition

You have an artery on each side of your neck called the carotid artery. This artery brings needed blood to your brain and face.

The blood flow in this artery can become partly or totally blocked by fatty material called plaque. A partial blockage is called carotid artery stenosis (narrowing). A blockage in your carotid artery can reduce the blood supply to your brain. A stroke can occur if your brain does not get enough blood.

There are two invasive ways to treat a carotid artery that is narrowed or blocked. One is surgery called endarterectomy. The other is a procedure called carotid angioplasty with stent placement.

Balloon angioplasty - short segment

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Balloon angioplasty - short segment

Alternative Names

Carotid angioplasty and stenting; CAS; Angioplasty - carotid artery

Description

Carotid angioplasty and stenting (CAS) is done using a smal surgical cut.

Why the Procedure Is Performed

There are two invasive ways to treat a narrowed or blocked carotid artery. One is a surgery called endarterectomy. The other is carotid angioplasty with stent placement.

Carotid surgery (endarterectomy) is a safe surgery and is almost always the first choice. This is because there is a higher chance of having a stroke during or soon after angioplasty procedure than there is with the open surgery.

As a result, carotid angioplasty and stenting is most often used only when the patient is too ill to have carotid endarterectomy. Other factors may make angioplasty better choice for treatment. These include which part of the carotid artery is narrowed or whether someone has had neck surgery in the past.

For more information see: Carotid artery surgery

Risks

Risks of carotid angioplasty and stent placement are:

Before the Procedure

Your doctor will do a thorough physical exam and several medical tests.

Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.

During the 2 weeks before your surgery:

Do NOT drink anything after midnight the night before your surgery, including water.

On the day of your surgery:

After the Procedure

After surgery, your doctor may want you to stay in the hospital overnight so that nurses can watch you for any signs of bleeding, stroke, or poor blood flow to your brain. You may be able to go home the same day if your procedure is done early in the day and you are doing well.

Outlook (Prognosis)

Carotid artery angioplasty may help lower your chance of having a stroke. But you will need to make lifestyle changes to help prevent plaque buildup, blood clots, and other problems in your carotid arteries over time. You may need to change your diet and start an exercise program if your doctor tells you exercise is safe for you.

References

International Carotid Stenting Study Investigators. Dobson EJ, Featherstone RL, Bonati LH, van der Worp HB, et al. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial. Lancet. 2010;375:985-997.

Murad MH, Shahrour A, Shan ND, et al. A systematic review and meta-analysis of randomized trials of carotid endarterectomy vs. stenting. J Vasc Surg. 2011 Mar;53(3):792-7.

Eisenhauer AC, White CJ, Bhatt DL. Endovascular treatment of noncoronary obstructive vascular disease. In: Bonow Ro, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa:Saunders Elsevier;2011;chap 63.